AUTHOR=Frentzel Dominik , Judanin Grigorij , Borozdina Olga , Klucken Jochen , Winkler Jürgen , Schlachetzki Johannes C. M. 

TITLE=Increase of Reproductive Life Span Delays Age of Onset of Parkinson’s Disease

JOURNAL=Frontiers in Neurology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00397

DOI=10.3389/fneur.2017.00397

ISSN=1664-2295

ABSTRACT=One striking observation in Parkinson’s disease is the remarkable gender difference in incidence and prevalence of the disease. Data on gender differences in regard of disease onset, motor and non-motor symptoms as well as dopaminergic medication is limited. Furthermore, whether estrogen status affects disease onset and progression in Parkinson’s disease is controversially discussed.
In this retrospective single-center study we extracted clinical data of 226 ambulatory PD patients and compared age of disease onset, disease stage, motor impairment, non-motor symptoms, and dopaminergic medication between genders. We applied a matched-pairs design to adjust for age and disease duration. To determine the effect of estrogen-related reproductive factors including number of children, age at menarche and menopause on age of onset, we applied a standardized questionnaire and performed a regression analysis.
The male to female ratio in the present Parkinson’s disease cohort was 1.9 to 1 (147 men vs. 79 women). Male patients showed increased motor impairment compared to female patients. The levodopa equivalent daily dose of male patients was increased by 18.9% compared to females. Matched-pairs analysis confirmed the increased dose of dopaminergic medication in male patients. No differences were observed in age of onset, type of medication, and non-motor symptoms between both groups. Female reproductive factors including number of children, age at menarche, and menopause were positively associated with a delay of disease onset up to 30 months.
The disease-modifying role of estrogen related outcome measures warrants further clinical and experimental studies targeting gender differences, specifically hormone dependent pathways in Parkinson’s disease.